Publications by authors named "Evan M Schwechter"

Background: Research in surgical fields other than orthopedics has demonstrated high patient satisfaction with non-traditional telerounding modalities.

Questions/purposes: We sought to determine patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores of patients who experienced telerounding in the post-operative period after undergoing total joint arthroplasty (TJA).

Methods: Fifty consecutive TJA patients were prospectively enrolled to receive telerounding.

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The consequences of sickle cell disease (SCD) include ongoing hematopoietic stress, hemolysis, vascular damage, and effect of chronic therapies, such as blood transfusions and hydroxyurea, on hematopoietic stem and progenitor cell (HSPC) have been poorly characterized. We have quantified the frequencies of nine HSPC populations by flow cytometry in the peripheral blood of pediatric and adult patients, stratified by treatment and control cohorts. We observed broad differences between SCD patients and healthy controls.

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We describe the case of a 57-year-old female who underwent bilateral ceramic-on-polyethylene total hip arthroplasties performed in 2015. She presented to us in 2018 with headaches, fatigue, and right hip pain 5 months after an atraumatic right polyethylene liner failure for which she did not seek treatment. She was found to have imaging consistent with an adverse local tissue reaction and massive pseudotumor formation.

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Distal femur fractures (DFFs) in elderly patients historically were difficult to treat because of osteoporotic bone, comminution, and intra-articular involvement. Current surgical treatment options, including intramedullary nailing, internal fixation, and external fixation, are complicated by prolonged immobility, malunion, and nonunion. Furthermore, fixation increases the complexity of subsequent arthroplasty.

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Case: Gout is a rarely reported cause of a painful knee following total knee arthroplasty, but it can mimic infection in its symptomatology and workup. Two individuals who had previously undergone a knee replacement and had a history of gout had symptoms of infection. These patients presented with knee warmth and effusion, and they had elevated inflammatory markers and synovial cell counts.

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Previous study at our institution demonstrated that scrubbing a methicillin-resistant Staphylococcus aureus (MRSA)-coated titanium disk with chlorhexidine gluconate (CG) solution achieved superior biofilm eradication compared to alternative solutions. The current study aimed to identify the minimum CG concentration for effective bacteria eradication of an in vitro periprosthetic joint infection (PJI) model. MRSA colony-forming units (CFUs) were counted following simulated irrigation and debridement with varying CG solutions before and after a 24-hour reincubation period.

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Case: In recent years, atypical femoral fractures (AFFs) associated with bisphosphonate use have increasingly been reported, but current definitions limit their diagnosis to native femora. Atypical periprosthetic fractures are rare. We present a case of a Vancouver type-C periprosthetic fracture that was recognized as an AFF following nonunion.

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Today's most basic and important total knee replacement design concepts arose out of an earlier era in which 2 distinct approaches emerged, functional and anatomic. Functional approaches simplified knee kinetics, were easier to implant, and gained widespread popularity, in part, from their inventory control. Anatomic approaches were an attempt to recreate normal knee motion with low prosthetic contact stress.

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Acute postoperative and acute, late hematogenous prosthetic joint infections have been treated with 1-stage irrigation and debridement with polyethylene exchange. Success rates, however, are highly variable. Reported studies demonstrate that detergents are effective at decreasing bacterial colony counts on orthopedic implants.

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In adult diabetic patients, periods of hyperglycemia may be associated with exacerbation of focal seizures. Our objective was to determine in the adult rats the correlation between seizure susceptibility and extracellular glucose concentration in two models of seizures. Male rats were injected with two doses of streptozocin (40 mg/kg IP) on 2 consecutive days to induce diabetic hyperglycemia.

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